Hepatic artery aneurysm

　　1. Etiology

　　Common causes include trauma, biliary tract infection, polyarteritis nodosa, arteriosclerosis, erosion of the arterial wall by gallstones, etc. Trauma and infection-induced cases are usually pseudo-aneurysms; degenerative changes in the vascular wall or congenital developmental defects may also be causes of the disease.

　　2. Pathogenesis

　　Hepatic artery aneurysms usually present as cystic, with diameters ranging from 2 to 10 cm. Most hepatic artery aneurysms are located extracorporeally, while true intracorporeal aneurysms are relatively rare, and pseudo-aneurysms caused by bacterial infection are more common. Hepatic artery aneurysms can compress the common bile duct, hepatic duct, and cystic duct, leading to intracorporeal biliary duct necrosis, extracorporeal biliary tract obstruction, and liver infarction. The vessel wall often shows non-specific inflammatory changes, 25% have arteriosclerosis or calcification, and granulation tissue, thrombus, and hemorrhage can also be seen.

　　Rupture of hepatic artery aneurysm is the most serious and common complication, which often communicates with the biliary tract after rupture, causing acute upper gastrointestinal hemorrhage; if the aneurysm communicates with the portal vein, portal hypertension can occur. A small number of cases may also rupture into the abdominal cavity, causing abdominal hemorrhage and hemorrhagic shock. Recurrence of aneurysm rupture is a severe complication of endovascular embolization, caused by abrupt blood pressure fluctuations, mechanical stimulation during surgery, and changes in coagulation mechanism due to anticoagulant therapy after surgery. The rupture of the aneurysm and the mortality rate increase with age. Patients may suddenly appear with anxiety, expressions of pain, restlessness, severe headache, varying degrees of consciousness disorders, and urinary incontinence. Emergency CT shows subarachnoid hemorrhage, and lumbar puncture shows bloody cerebrospinal fluid. It is essential to carefully observe patients at all times and promptly notify the doctor for timely treatment. After surgery, the patient should be closely observed in the neurosurgical ICU for changes in consciousness, pupil size, limb movement, vital signs, especially blood pressure and respiratory changes. For those with high blood pressure, controlled lowering of blood pressure to around 16/11Kpa is recommended.

　　There is currently no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of the disease.

　　Switch to a diet that can reduce blood pressure and atherosclerosis may help prevent the development of aneurysms. Understand whether you are in the risk period for an aneurysm and take appropriate measures to prevent aneurysm formation, especially if you have a family history of stroke or heart disease. Change your dietary habits and lifestyle to improve your overall health status, engage in regular exercise, pay attention to your diet, and quit smoking if you smoke.

　　1. Suitable Foods

　　High-calorie and nutritious foods such as lean meat, chicken, fish, dairy products, and soy products. Fresh vegetables such as celery, spinach, tomatoes, radishes, garlic, fresh bamboo shoots, etc. Sea products such as kelp, laver, jellyfish, algae, and those with habitual constipation should often eat bananas, persimmons, watermelons, cantaloupes, water chestnuts, honey, royal jelly, cornstarch, and others. Black fungus, silver ear, etc.

　　2. Unsuitable Foods

　　Avoid greasy foods, smoking and drinking, high cholesterol foods such as animal brains, spinal cord, internal organs, yolks, shellfish (such as clams), and mollusks (such as squid, cuttlefish, fish eggs).

　　3. Food Therapy Formula

　　1. Salvia and Field Chicken Soup

　　[Formula] Salvia miltiorrhiza 24 grams, field chicken 250 grams, jujube 4 pieces.

　　[Preparation] Select a live frog, kill it, remove the intestines and claws and skin, clean it. Wash salvia miltiorrhiza and dried red dates (with the seeds removed) clean. Put all the ingredients together in a pot, add an appropriate amount of water, bring to a boil over high heat, then simmer over low heat for 2 hours, and season with salt to taste.

　　[Usage] Drink the soup and eat the meat, can be taken regularly.

　　2. Hawthorn and Malt Drink

　　[Ingredients] Hawthorn 20 grams, malt 10 grams.

　　[Preparation] Cut hawthorn and clean it, clean malt, put them together in a covered cup, pour boiling water over them, and steep for 2 to 3 minutes. It can be drunk after steaming.

　　[Usage] Take the juice as tea, can be taken regularly.

　　3. Notoginseng and Turtle Shell Stewed Lean Pork

　　[Ingredients] Lean pork 120 grams, notoginseng 10 grams, turtle shell 30 grams, dried red dates 4 pieces.

　　[Preparation] Wash notoginseng, turtle shell, and dried red dates (with the seeds removed) clean. Wash lean pork clean and cut into pieces. Put all the ingredients together in a stewing pot, add an appropriate amount of boiling water, simmer over low heat for 2 to 3 hours, and season with salt to taste.

　　[Usage] Drink the soup and eat the meat, can be taken regularly.

　　1. Treatment

　　The mortality rate after rupture of the hepatic artery aneurysm can be as high as 40% to 100%, so once a hepatic artery aneurysm is diagnosed, it should be treated surgically or treated by interventional means. Since ligation of the hepatic artery usually does not cause serious liver blood supply disorders, it can be first attempted to block the hepatic artery, observe the liver blood supply, and if there is no blood supply obstruction, it can be ligated or ligated and excised. If there is a blood supply obstruction, it is necessary to excise and perform bypass autologous venous or artificial vascular bridge surgery. For hepatic artery aneurysms of the hepatic artery branches within the liver, partial hepatectomy of the corresponding hepatic segment (lobe) can be performed.

　　Postoperative patients should be monitored and treated in the ICU, and if vascular transplantation bridge surgery is performed, anticoagulant treatment should be continued for 1 to 2 weeks after surgery.

　　In recent years, with the improvement of interventional equipment and technology, for those aneurysms at the distal end of the hepatic artery, especially those located close to the second and third hepatic gates, due to their dangerous anatomical location, the risk of surgical operation is extremely high. They can be treated by superselective vascular embolization, including releasing miniature rings, detachable balloons, coils, and embolic glue, etc., to treat hepatic artery aneurysms and their rupture, with a success rate of up to 76%.

　　2. Prognosis

　　The prognosis of this disease largely depends on early diagnosis and corresponding surgical treatment. Once it bursts and bleeds, the mortality rate is very high.